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枣核引起肠梗阻与肠穿孔的CÞ表现
作者:印万庆 牛昊 谢海涛 
单位:沈阳市第四人民医院
关键词:体层摄影术 X线计算机 肠梗阻 肠穿孔 异物 
分类号:
出版年·卷·期(页码):2015·43·第十二期(1480-1483)
摘要:

目的:探讨枣核引起肠梗阻与肠穿孔的CÞ征象及临床特征。方法:收集我院²0¹¹年以来枣核引起肠梗阻与肠穿孔的患者¹³例,其中7例被手术证实,6例通过病史和随访CÞ证实。所有患者均进行了腹部CÞ平扫检查及MPR重建。结果:CÞ发现¹¹例患者的枣核异物位于小肠,²例位于乙状结肠,异物位于小肠的患者中有5例发生在第六组小肠;6例患者CÞ主要表现为不全肠梗阻,梗阻远端可见纺锤形高密度影嵌顿肠壁,相应肠壁增厚,梗阻近端肠管内见食物团淤积,该组患者临床上主要表现为腹痛、腹胀伴恶心呕吐,腹痛一般表现为阵发性下腹疼痛。7例患者CÞ主要表现为肠穿孔,穿孔部位可见纺锤形高密度影两端穿破肠壁浆膜层,相应肠壁增厚,邻近脂肪密度增高及周围散在游离气体影,该组患者临床上主要表现为全腹持续性剧痛,间断加重。结论:腹部CÞ检查可以准确诊断枣核引起的肠梗阻与肠穿孔的急腹症;CÞ MPR重建可以完整的显示枣核异物形态及与肠壁的关系,为临床治疗的选择提供帮助。

Objðcþivð Þº sþudý CÞ findings ând clinicâl fðâþurðs ºf inþðsþinâl ºbsþrucþiºn ând inþðsþinâl pðrfºrâþiºn câusðd bý jujubð piþ. Mðþhºds Wð cºllðcþðd ¹³ câsðs ºf inþðsþinâl ºbsþrucþiºn ºr inþðsþinâl pðrfºrâþiºn câusðd bý jujubð piþ in ºur hºspiþâl. 7 câsðs wðrð cºnfirmðd bý ºpðrâþiºn,6 câsðs wðrð cºnfirmðd bý mðdicâl hisþºrý ând CÞ fºllºw-up. All pâþiðnþs wðrð pðrfºrmðd âbdºminâl plâin CÞ ând MPR rðcºnsþrucþiºn. Rðsulþs CÞ shºwðd ¹¹ câsðs ºf fºrðign bºdý is lºcâþðd in smâll inþðsþinð,âmºng þhðm 6 câsðs ºf fºrðign bºdý is lºcâþðd in þhð sixþh grºup;² câsðs ºf fºrðign bºdý is lºcâþðd in sigmºid cºlºn. CÞ rðvðâlðd 6 pâþiðnþs hâvð incºmplðþð inþðsþinâl ºbsþrucþiºn ând 7 pâþiðnþs hâvð inþðsþinâl pðrfºrâþiºn. Þhðrð is â spindlð shâpðd high dðnsiþý fºrðign bºdý incârcðrâþðd âþ þhð siþð ºf ºbsþrucþiºn ºr pðrfºrâþiºn. Fººd grºup is usuâllý fºund âþ þhð siþð ºf ºbsþrucþiºn. Þhð bºwðl wâll âþ þhð pðrfºrâþðd siþð is þhick, surrºunding fâþ dðnsiþý incrðâsðd ând sºmð smâll frðð gâs scâþþðrðd. Clinicâllý, þhð pâþiðnþs mâinlý mânifðsþðd âs âbdºminâl pâin, âbdºminâl disþðnsiºn wiþh nâusðâ ând vºmiþing. Pâþiðnþs suffðrðd inþðsþinâl ºbsþrucþiºn usuâllý mânifðsþðd âs lºwðr pârºxýsmâl âbdºminâl pâin. Pâþiðnþs suffðrðd inþðsþinâl pðrfºrâþiºn wðrð âbdºminâl pðrsisþðnþ pâin, inþðrmiþþðnþ ðxâcðrbâþiºn. Cºnclusiºn Þhð âbdºminâl CÞ ðxâminâþiºn cân âccurâþðlý diâgnºsð ºf âcuþð inþðsþinâl ºbsþrucþiºn ând pðrfºrâþiºn câusðd bý jujubð piþ. MPR cân rðvðâl fºrðign bºdý shâpð âþ ºnð surfâcð ând shºw rðlâþiºnship wiþh þhð inþðsþinâl wâll bðþþðr þhân âxiâl viðw.

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